Therapeutic strategy of revascularization for acute ischemic stroke after approval of intravenous rt-PA

Abstract

We investigated the treatment outcome of revascularization for acute ischemic stroke and reviewed therapeutic strategy of endovascular therapy and intravenous rt-PA therapy after the approval of rt-PA. We performed adaptive determination of revascularization using MRI (DWI/PWI) for all acute stage, and intravenous rt-PA therapy was performed only for confirmed cases in a principal bronchus artery in MRA.
We took intravenous rt-PA therapy for cardioembolic MCA occlusion of less than 3 hours and performed endovascular treatment which were the brain blood vessel expansion technique that we used UK intraarterial injection or a balloon and stent for besides it. As for the treatment strategy of revascularization, that we perform the treatment that conformed to eligibility criteria of intravenous rt-PA therapy is recommended for future acute stage without receiving it for a case of less than 3 hours than the onset. In addition, it should be reviewed adaptation of brain endovascular treatment for the patient beyond three hours by evaluating cerebral circulation dynamics by imaging such as DWI/PWI MR. As for the revascularization, maintenance of early transportation organization of the local acute stroke patient and architecture of inside the hospital organization are important for acute stage after intravenous rt-PA therapy certification.